liver function test Flashcards
what is cholestasis
failure to produce or excrete bile
what are the classifications of liver disease
infection drug induced autoimmune billiary vascular metabolic neoplastic
what is acute hepatic failure
development of dysfunction within 24 weeks of disease
what is chronic hepatic failure
progressive decline in liver function with established disease
what are the main causes of acute hepatitis
drug e.g. paracetamol
inadequate perfusion
infection
what are common causes of chronic liver disease
alcoholic fatty liver disease
chronic active hepatisis
primary billiary cirrhosis (cholangitis)
what are the consequences of chronic liver disease
cirrhosis portal hypertension ascites renal failure oedema bruising
what are the consequences of portal hypertension
gastric/ oesophageal/ anal varices
hepatic encephalopathy
hypersplenism
what are the features of liver failure
inadequate synthesis of albumin and clotting factors
inability to eliminate nitrogenous waste and bilirubin
what is hepatic encephalopathy
products normally
metabolised by the liver accumulate in
the systemic circulation.
e.g. ammonia
what liver function tests are there
aminotransferase
bilirubin
ALP for biliary epithelial damage/ obstruction
albumin
how is bilirubin excreted
as urobilinogen or in bile
what does AST and ALT stand for
aspartate aminotransferase and alanine aminotransferase
non specific markers of acute liver damage
what is ALP
increased in liver disease due to increased synthesis in response to cholestasis
it is a protein
alkaline phosphatase
what is gamma GT
raised in cholestasis also affected by alcohol and drugs
what are the limiations of biochemical tests
lack of specificity
may be over sensitive
enzymes are not exclusively found in the liver
what can LFTs be used for in asymptomatic patients
check for haemolysis
pregnancy
skeletal muscle disorders
what is the marker for liver cancer
alpha fetoprotein
what are copper studies done for
Wilson’s disease
what are antibodies assessed for
chronic active hepatitis
how else can the liver be investigated
liver biopsy
radiology
what is Gilbert’s syndrome
high levels of bilirubin
liver has difficulty removing bilirubin from the blood
bilirubin levels fluctuate
usually present during illness or fasting
no treatment required
what is pruritis
itching
what is high ALP with normal ALT indicative of
cholestasis
what can caused raised levels of ALP
pregnancy
what does alchohol affect
levels of GGT
what are the possible causes of increased ALP
cholestasis
pregnancy
bone growth
could be increased in chronic or acute liver failure
what LFT would you expect to find in cholestasis
increased bilirubin, ALP, gamma GT, ALT
what would you expect to find in chronic liver failure
normal results or slightly increased
what would you expect to find in acute liver failure
increased bilirubin and ALT
where is ALP found
lining the bile ducts, placenta, bones
a patient has raised ALP and GGT
bile tract disease
raised ALP normal GGT
bone disease or pregnancy likely
